Feminist health psychology and abortion : towards a politics of transversal relations of commonality

In 1992 Speckhard and Rue argued in the Journal of Social Issues for the recognition of a diagnostic category, post-abortion syndrome (PAS). This term was first used in 1981 by Vincent Rue in testimony to the American Congress, but was only formalised in a published paper a decade later. Speckhard and Rue (1992) posit that abortion is a psychosocial stressor that may cause mild distress through to severe trauma, creating the need for a continuum of categories, these being post-abortion distress, post-abortion syndrome and post-abortion psychosis. PAS, which is the main focus of their paper, and which has taken root in some professional language as well as lay anti-abortion discourse, is described as a type of post-traumatic stress disorder

Incidence and management of pulmonary embolism following spinal surgery occurring while under chemical thromboprophylaxis

Patients undergoing spinal surgery are at risk of developing thromboembolic complications even though lower incidences have been reported as compared to joint arthroplasty surgery. Deep vein thrombosis (DVT) has been studied extensively in the context of spinal surgery but symptomatic pulmonary embolism (PE) has engaged less attention. We prospectively followed a consecutive cohort of 270 patients undergoing spinal surgery at a single institution. From these patients, only 26 were simple discectomies, while the largest proportion (226) was fusions. All patients received both low molecular weight heparin (LMWH) initiated after surgery and compressive stockings. PE was diagnosed with spiral chest CT. Six patients developed symptomatic PE, five during their hospital stay. In three of the six patients the embolic event occurred during the first 3 postoperative days. They were managed by the temporary insertion of an inferior vena cava (IVC) filter thus allowing for a delay in full-dose anticoagulation until removal of the filter. None of the PE patients suffered any bleeding complication as a result of the introduction of full anticoagulation. Two patients suffered postoperative haematomas, without development of neurological symptoms or signs, requiring emergency evacuation. The overall incidence of PE was 2.2% rising to 2.5% after exclusion of microdiscectomy cases. The incidence of PE was highest in anterior or combined thoracolumbar/lumbar procedures (4.2%). There is a large variation in the reported incidence of PE in the spinal literature. Results from the only study found in the literature specifically monitoring PE suggest an incidence of PE as high as 2.5%. Our study shows a similar incidence despite the use of LMWH. In the absence of randomized controlled trials (RCT) it is uncertain if this type of prophylaxis lowers the incidence of PE. However, other studies show that the morbidity of LMWH is very low. Since PE can be a life-threatening complication, LMWH may be a worthwhile option to consider for prophylaxis. RCTs are necessary in assessing the efficacy of DVT and PE prophylaxis in spinal patients

Pedicle morphology of the thoracic spine in preadolescent idiopathic scoliosis: magnetic resonance supported analysis

Although several studies have been reported on the adult vertebral pedicle morphology, little is known about immature thoracic pedicles in patients with idiopathic scoliosis. A total of 310 pedicles (155 vertebrae) from T1 to T12 in 10–14 years age group were analyzed with the use of magnetic resonance imaging and digital measurement program in 13 patients with right-sided thoracic idiopathic scoliosis. Each pedicle was measured in the axial and sagittal planes including transverse and sagittal pedicle width and angles, chord length, interpedicular distance and epidural space width on convex and concave sides of the curve. The smallest transverse pedicle widths were in the periapical region and the largest were in the caudal region. No statistically significant difference in transverse pedicle widths was detected between the convex and concave sides. The transverse pedicle angle measured 15.56° at T1 and decreased to 6.32° at T12. Chord length increased gradually from the cephalad part of the thoracic spine to the caudad part as the shortest length was seen at T1 convex level with a mean of 30.45 mm and the largest length was seen at T12 concave level with a mean of 41.73 mm. The width of epidural space on the concave side was significantly smaller than that on the convex side in most levels of the curve. Based on the anatomic measurements, it may be reasonable to consider thoracic pedicle screws in preadolescent idiopathic scoliosis